Chapter 655: Lymphadenectomy
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
Lymphadenectomy was the most energy-consuming part when operating on patients who were suffering from cancer.
Lymph nodes were part of the human lymphatic systems and were spread around various organs. Each lymph node was about the size of a grain of rice, and they were scattered loosely all over the human body. The number and position of lymph nodes varied between people.
We live in a world where some people are born with their hearts on the right side. When you take this into consideration, you can imagine how hard it was to clear all the lymph nodes with cancerous cells of a person’s body. It was just like playing hide-and-seek.
It was actually even more troublesome compared to playing hide-and-seek, as the human body was not a flat surface. When doctors operated on patients, not only did they have to take the position of anatomical structures into consideration, but they also had to pay attention to the spaces within the human body. For example, the inner cavity of organs and other closed spaces that were surrounded by organs as well as muscles, fats and other tissues.
Other than the lymph nodes that were exposed, doctors also had to remove the lymph nodes within closed spaces that were in the periphery.
This was the time when a surgeon’s anatomical dissection skills were put to test. The abdominal cavity was not actually large. You just have to lower your head, look at your own belly and visualize how it would look like if you had a six-pack. Your abdominal cavity would be about the size of the six-pack. Due to how small the abdominal cavity was and how it was crowded full of organs such as the liver, spleen, gallbladder, stomach, and kidneys, there was very little room for error.
This was especially true when it came to lymphadenectomy, as a surgeon could easily remove lymph nodes that belonged to other organs by mistake.
As cancer patients were very weak, removing the wrong lymph nodes posed a serious risk.
Even though Feng Zhixiang allowed Ling Ran to carry out lymphadenectomy, he still paid close attention to Ling Ran’s maneuver. He dared to let Ling Ran do it because it was in his nature to provide opportunities for junior doctors. It was also because he had seen Ling Ran removing the lymph nodes around a patient’s liver.
Feng Zhixiang believed that Ling Ran was at least adept in removing the lymph nodes around the patient’s liver, and this would make things a lot easier for himself.
Of course, surgeons who were capable of removing the lymph nodes in a patient’s liver were probably also adept at removing the lymph nodes in other areas of the body. At the end of the day, if a surgeon was highly knowledgeable when it came to human anatomy, he basically did not require any special skills to carry out lymphadenectomy.
However, a surgeon must be very meticulous when performing lymphadenectomy, as it was very easy to miss a lymph node while doing it. The purpose of lymphadenectomy was prevention as there might be cancerous cells in the patients’ lymph nodes. If a surgeon were to miss a lymph node, not only would they be irresponsible towards the patient involved, but they were also putting their hard work to waste. If the patient’s cancer cells could spread easily even after surgery, it meant that the surgeon had performed the surgery for nothing.
Feng Zhixiang removed the lymph nodes himself as he watched Ling Ran. He said, “You don’t have to worry about being slow or making mistakes when carrying out lymphadenectomy. Your biggest enemy is the lack of focus. So, do not be in a rush and do things in a hurry. There’s no need for this.”
This had always been Feng Zhixiang’s belief. Ling Ran merely hummed in acknowledgment and did not slow down at all.
As Ling Ran possessed Perfect Level Lymphadenectomy, he could spot the lymph nodes very easily. This was why Feng Zhixiang’s advice was really only for other general situations to him, and it would not be suitable for him to follow it given the situation right now.
Feng Zhixiang glanced at Ling Ran a few more times, and when he saw that Ling Ran was quite adept in lymphadenectomy, he did not enforce his belief upon Ling Ran. He placed most of his focus on his task at hand and said with a smile, “Lymphadenectomy is seriously not easy on doctors. The workload is massive, and we need to be very meticulous. It’s very arduous for doctors my age. But young doctors often miss a lymph node too…”
Xu Wen saw that Ling Ran was not in the mood to chit-chat, and had no choice but to join the conversation. He took the opportunity to flatter Feng Zhixiang while he was at it. “Professor Feng, you’re being too humble. I have watched you operate before, and you were really good at lymphadenectomy. The patient’s prognosis was amazing too.”
“Did you? Yes, a good prognosis is very important. Don’t we operate on patients just so that they would have a good prognosis? Shouldn’t we make perfecting every single step of the surgery our aim? What I can’t stand the most are those surgeons who use curettes like their lives depend on it. There are surgeons who scrape all of the patients’ separated tissues and perform hemostasis by heat all the time. They’d scrape and scorch the patient’s tissues throughout the surgery. Those who don’t know what is going on would think that they are chefs.” Professor Feng snorted a few times and said, “I won’t be naming names today, but patients operated by those doctors experience postoperative hemorrhage all the time. If they continue to do this, something is bound to go wrong one day!”
Xu Wen’s lips trembled nonstop when he heard this, and he had absolutely no idea how to continue to flatter Professor Feng.
Feng Zhixiang said that he “won’t be naming names”, but their circle was pretty small, and the experienced doctors who were present definitely knew the names of the doctors who liked to use curettes and perform hemostasis by heat…
Xu Wen thought about it long and hard. He finally managed to say something flattering, “Doctor Ling, the stitches you make are really beautiful.”
Ling Ran had encountered a suture surface point and was quickly suturing it.
When Feng Zhixiang saw this, he was even more pleased with Ling Ran. He nodded and said, “That’s right, the way of handling bleeding points is by suturing them. I don’t know what’s so hard to understand about this. Nowadays, certain doctors perform hemostasis by heat all the time. They would place the endotherm knife on the bleeding point for almost twenty seconds. There were even those who do this for around thirty or forty seconds, and this really destroys the patient’s tissues. Yes, they would be able to stop the bleeding during the surgery. But what happens after the surgery? The tissues would be all destroyed, and the resulting damage is many more times worse compared to if they were to suture the bleeding point…”
“Doctor Ling is indeed very adept when it comes to suturing patients. He’s got all the basic techniques down.” Xu Wen did not dare to echo what Feng Zhixiang said, but he did not want to go out of topic. It was hard for him to continue to come up with flattering words.
Feng Zhixiang hummed in acknowledgment and continued to take his time in removing the patient’s lymph nodes. He was thinking about how this conversation was not going too badly. After all, even though Xu Wen was good at flattering other people, he was not close to Feng Zhixiang and did not know the right things to say. In comparison, there were doctors in Feng Zhixiang’s Center of General Surgery who were better at flattering him. However, he did not bring them along this time.
“Professor Feng, should I remove the lymph nodes in the head of the pancreas too?” Ling Ran stretched his neck to relax the muscles in his neck and shoulders as he waited for Feng Zhixiang to make way for him.
Feng Zhixiang froze for a moment. He then lowered his head and said in astonishment, “You’ve removed all the lymph nodes in the liver?”
“Yes.”
“That was fast.” Feng Zhixiang was surprised that Ling Ran was done in the short span of time that he was not paying attention to Ling Ran. He took a look at the patient’s liver and saw that all the lymph nodes are gone.
Even though there would be a retention of lymph after all the lymph nodes were removed, the human body would soon adjust and the lymph would be drained through other passages. Hence, it would be better if more lymph nodes were removed.
“Professor Feng?” Ling Ran called out again.
Feng Zhixiang followed Ling Ran’s gaze and saw that the instrument he was holding was blocking Ling Ran a little.
Even though Ling Ran was only the first assistant right now, since they were removing the patient’s lymph nodes together, he should not be so calculative about things.
Hence, Feng Zhixiang moved a little so that Ling Ran could have a bit more space.
“I’ll continue, then.” Ling Ran stated. He then lowered his head and continued removing the patient’s lymph nodes at lightning speed.
Feng Zhixiang, too, lowered his head and continued. When he turned to look at Ling Ran again, he saw that Ling Ran had removed a lot of lymph nodes. If a person were to compare Feng Zhixiang and Ling Ran’s speed, it would be like comparing a snail and a cow’s speed of eating grass.
“I’ll leave the rest up to you.” Feng Zhixiang blushed a little from the embarrassment, but it was not obvious because of his dark skin and the wrinkles of his face. He decided to utilize his power as the chief surgeon and make Ling Ran remove the rest of the lymph nodes.
Ling Ran hummed in acknowledgment and continued with the task at hand.
The mutated cells in the patient’s abdominal cavity that were total eyesores slowly disappeared.
This sight made Feng Zhixiang feel extremely good as he stood with his arms across his chest.
“Things could’ve been worse for the patient and his family members. They’re lucky to have Ling Ran here.” Feng Zhixiang suddenly felt a little emotional when he thought of the middle-aged woman who kowtowed nonstop to him.
